The debates around research against Covid-19 have highlighted the importance of the principles born in 1947 during the trial of Nazi doctors, and of the foundations of modern biomedical ethics.
Scientific research must be based on the ten fundamental ethical principles developed after the Nazi crimes, even in the race for a vaccine to fight the coronavirus.
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These are discussions that have recently come to the fore, thanks to the Covid-19 crisis . Around a nagging question: should we develop exceptional principles to accelerate research? On the other side of the Atlantic, for example, thousands of people have declared themselves volunteers to be inoculated with the virus in order to test a vaccine. In Europe, others have castigated the use of placebos to evaluate drugs. Didn’t the urgency of putting an end to the pandemic justify, in fact, skipping a few steps to get treatments and vaccines into circulation more quickly?
Precisely, replied their opponents, because a doctor should never harm his patient, according to an ancient medical principle ( “primum non nocere” , first do no harm). But also because it is necessary to remember that in terms of medical experiments, not everything is possible, even under the pretext of doing good.
This belief is rooted in the foundations of contemporary biomedical ethics, forged more than 70 years ago during the trial of Nazi doctors and their horrific experiments in prison and concentration camps. In The Nuremberg Doctors’ Trial (1), where he retraces the trial of German doctors which took place over six months from December 1946, the historian Bruno Halioua clearly shows how men used other human beings as means to achieve their ends. Most of the defendants are renowned doctors, sometimes university researchers. Far from repenting, they draw up a defense in front of the court based on the alleged relevance of their experiences. For the whole world, it is the awareness of monstrous practices.
10 basic principles of biomedical ethics
The trial results in the enunciation of 10 principles, which constitute the foundation of modern biomedical ethics. Among them, the need for the consent of a person involved in medical research, but also that for an experiment to produce beneficial results for society or to avoid any suffering. Nor can any experiment be conducted if it can lead to death. In short, an intangible principle was born: one cannot harm others under the pretext of helping or doing good to others.
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A year later, in 1948, the Geneva oath adopted by the World Medical Association proposed adding this sentence to the ancient Hippocratic oath: “Even under threat, I will not place my medical knowledge at the service of those who violate the laws of humanity. »
The Covid crisis has shown that these principles remain glaringly topical. As a response to those who felt, in recent months during the revision of bioethics laws , that it was necessary to get away from this historical reference, judging this reference “clumsy” or even somewhat outdated. However, certain principles remain indeed intangible, whatever the pretexts invoked.